notesblognepal.blogspot.com
Some major points to be
understood in the lesson
- Community health includes preventive, curative, promotive and rehabilitative aspects of health.
- Community health programme can only be achieved through the joint effort of the individual community and the country.
- The programme must be participated and managed by doctor, epidemiologists, teachers, researchers, sociologists, researchers, social activists and paramedical staff.
- The concept of community health started in England at the beginning of the 19th century.
- The failure of conventional health care services to address health needs of the community gave birth to the concept of community health.
- Furthermore, WHO has highlighted the concept of community health through primary health care system.
- Generally the community health covers the following aspects
a.
A balanced diet
i.
Sound and safe environment
·
The study of community health helps to keep the
healthy environment
·
Healthy manpower can be produced through
improvement in the community health
·
Health services can be provided to grassroots
level of the community
·
Study of community health encourages people for
social services
S.N
|
Health problem of Nepal
|
Condition
|
Major causes behind the prevalence/ reasons
how it bring health problems
|
1
|
Infectious diseases
|
Many Children of Nepal are
losing their life because of the general diseases like diarrhea. The other
diseases like dysentery, cholera, typhoid, worm infestation are also causing
problems for Nepalese people. The new diseases like HIV/ AIDS and hepatitis
have added a strong challenge in the health system of Nepal.
|
·
People hide their disease in the fear of
social hatred
·
Ignorance and superstition regarding disease
is strong
·
Lack of health knowledge
·
Inaccessible health services mostly for rural
population
·
Sanitation problem no supply of clean drinking
water
·
Unhygienic habit
·
Lack of proper vaccination
·
Late diagnosis of disease gives time to spread
in the community
·
Difficult landform that creates difficulty in service delivery
|
2
|
Malnutrition
|
Malnutrition is the
condition created due to the excess or less nutrients consumed. In the
context of Nepal may children and the pregnant women suffer from deficit
malnutrition. The common types of mal-nutrition in Nepal are marasmus,
Kwashiorkor, rickets, scurvy, anemia etc.
In Nepal, malnutrition plays a role in 60 percent of child deaths,
according to UN Children’s Fund (UNICEF).
|
·
Infections aggravate problem
·
Limited access to sanitation and safe water
·
Poor eating habits and agriculture investments
·
Nutrition historically low priority
·
Poverty, so cannot afford to buy nutritional
diet
·
Lack of education in preparing food from
locally available resources
·
Low food and less care to the pregnant women
results to anemia
·
Shortage of food supply in rural areas due to
lack of proper transportation
·
Defective food preparation practices
·
Food taboos and food faddism
|
3
|
High Infant Mortality rate
|
At least 33 out of every
1000 newborn children die in Nepal. It
is found that 42 per cent of newborn mortality occurred due to no good and
easy-going environment for child delivery while 29 per cent is caused by
under-weight on birth. Likewise,
sometimes child died within the womb of mother having weak health condition
due to suffocation. (source Republica August 5)
|
·
Lack of education and ignorance
·
Lack of proper health services
·
Lack of adequate birth spacing
·
Lack of immunization
·
Poor sanitation and immunization
·
Socio-cultural beliefs which promotes
traditional unscientific healing practices
·
Lack of proper infant care
·
Early conception by mother
·
High prevalence of infectious diseases which
severely affect infant
|
4
|
High maternal mortality rate
|
The maternal mortality ratio
is to high in Nepal as about 281 Nepali women per 100,000 live births die of
complications during childbirth, is said by UNICEF
|
·
Difficult weather conditions and scarcity of
roads are challenges in the delivery of maternal health services which are
compounded by widespread poverty and lack of adequately trained human
resources.
·
The pregnant woman are not given proper care
in the family, she need to heavy work even during the pregnancy
·
Traditional values, norms and practices
·
Early age of conception and less birth spacing
(some points can be extracted from the infant mortality rate as well)
|
5
|
Poverty
|
Development plans in Nepal
have focused on poverty alleviation for decades, and poverty alleviation
remains a declared principal objective of government. However, its people are
no less poor than they were a decade ago. The survey of 2004 show that 31% of
Nepalese people are living below the poverty line.
|
Poverty is responsible to cause various
health related problems.
·
Poor people cannot afford modern health
facilities and services
·
Their living standard is poor in which
sanitation and cleanliness are neglected or they do not have knowledge or
ability to practice such behavior
·
No proper balance diet so higher chances of
malnutrition
·
Poor health condition of children and mother
·
No proper management of human wastes disposal,
lacks safe drinking water which increases the risk of various communicable
diseases.
|
6
|
Rapid Population growth
|
RPG
is regarded as negative health indicators. In the last few census of
Nepal the population growth rate was around 2 and the economic growth
rate of the country was also around it, which have caused various complex problems in Nepal. The problems are
supposed to aggravate in the days to come.
|
It is responsible for the following health
problems
·
The increasing density of population has
increased in destruction of cultivable land and fragmentation of land which
brought the problem of reduction in production and pressure of housing.
·
Higher the population lowers the chances of
employment opportunity which affect in buying health related accessories.
·
Inadequate education and health facilities
·
Less harmony and hardship in living the life
·
Higher environmental degradation can result to
more health problems.
|
7
|
Nepalese life style
|
·
We use more amounts of spices and oil which
affects the nutritional value of food and is responsible for various health
ailments and obesity.
·
Certain culture allows the intake of alcohol,
which is responsible for certain kind of health problems
·
Our diet contains more amount of fat and
carbohydrate and less vitamins and minerals
·
Over-eating and fasting for longer time in
certain cultural events have resulted to certain kind of health problems in
Nepal.
|
Role of
individual, family and community in the solution of major health problems of
Nepal.
Role of individual
·
The individual who is the member of a community
must have a good habit of personal hygiene
·
The individual must be aware of the existing
health problems
·
The individual should be aware of the
environmental sanitation and should motivate others to keep the environment
healthy
·
The individual may set minimum standards of
education, hygiene, medical treatment and so on in the interest of the
community
· The individual may encourage the people for the
utilization of available health services
·
The individual may provide knowledge and skill
to others for healthy living
·
The individual may develop an attitude of
respect towards the law of health
·
The individual should modify and rectify the traditional
belief and superstition of health knowledge and practice
·
The individual may help to solve the health
problem by early reporting of sickness
·
Undertaking measures for prevention against
relapse or infection of the disease to others
·
An individual can be an initiator of any good
health related work. The individual can make a better path where other people
of the community can walk and reach to the destination of improved health
condition.
·
An individual can search or find out effective
solutions for certain kind of community health problems.
Role of family
·
The family can contribute by encouraging the
family members to participate in community health programme and activities. It
can help or support the family members to attain skills and knowledge about
health way of life.
·
Family may help to understand the fundamental
behavior patterns of the society. It makes the family members ready to function
well in the society.
·
Can contribute to collect fund essential to
develop community health in the community. The family can give moral, economic
and other sorts of support essential to make the community health programme
successful.
·
A family can set a good example of healthy
family, so that the other families living around such family can get
inspiration about better way of life.
·
Family can look after and promote the health of
child, helpless one and old people.
·
Family may set a basic norms and values of a
healthy living for the community
Role of the Community
·
It may provide facilities, manpower, logistic
support and economic resources essential to develop the community health status
·
Community can encourage certain individual or
families to adopt healthy way of life.
·
It can establish health organizations to solve
the community health problems
·
Community can be an effective medium through
which various types of health services can be distributed
·
Community can conduct occasional awareness
programme to wipe out superstitions and wrong practices prevailing in the
community.
·
Community can formulate various norms, set of
rules, regulations and values regarding promotion of health status of the
community.
·
It can make necessary arrangement of the various
goods and services essential for the community to improve the overall health
status.
·
It can inform the concerned authority or
organization to bring various types of health programme which can benefit the
people living in the community.
Health Post:
·
Health posts are the centers where primary
health care services are delivered
·
There is a provision of six health manpower in Hilly
and Himalayan region and seven health manpower in the Terai region.
·
The manpower available in the health post are;
Health assistant or senior auxiliary health worker, auxiliary health worker,
auxiliary nurse midwife, maternal child health worker, mukhiya and peon.
·
It provide general medical services including
leprosy treatment, control of epidemic, provides maternity services,
distributes family planning devices, surveillance of malaria and other
infectious diseases, it also provide clinics for children and other various
general health programme are conducted by health post.
·
The major aim of health post and sub-health post
is to provide minimum medical and preventive health services to the people of
the Ilaka through the medium level health worker.
·
In the recent years the government had made a
policy of upgrading health post in primary health center.
Primary health centre:
·
In health centers more health facilities are
available as compared with the health post. Health centers have a provision of
beds and trained physicians. It can provide higher level health services as
compared with health post. Health center provide both indoor and outdoor
services.
·
Health centre or primary health care centre is
controlled and directed by district health office.
·
One medical officer heads it with eleven other
personnel.
·
There is a provision of three beds one for
delivery and two for other emergency purposes.
Hospitals:
·
Hospitals are classified as general, special and
teaching hospitals on the basis of the services provided by them.
·
General hospitals provide treatment to all the
kind of diseases in a general way. They have basic infrastructure in the
treatment of all kind of diseases.
·
Special hospitals are the hospitals which are
established for the treatment of certain type of health problems. Such hospital
have infrastructure essential for the treatment of specific problems like
Cancer, ‘B.P Koirala Cancer Hospital, Eye Hospital, ‘Himalaya Eye Hospital,
Leprosy hospital, ‘Green pasture hospital, T.B hospital, mental hospital etc
are the example.
· Hospitals are classified into four categories onthe regional basis: District hospital, Zonal hospital, Regional Hospital and
Central hospital.
·
The hospital provides the curative health service
to the casualty. In conclusion we can say that the hospital is a place or
health institution having the facilities of laboratory, specialized medical
diagnosis and treatment and hospital beds for the curative health services of
the casualty.
·
It provide curative health services in two ways;
Outdoor patient and Indoor patient.
Note: Please learn the difference between health posts and health center,
health centers and hospitals, indoor and outdoor patient service.
notesblognepal.blogspot.com
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